From the Guidelines
Blood tests for diagnosing sexually transmitted diseases (STDs) should include HIV, syphilis, hepatitis B, and hepatitis C, as these are crucial for early detection and prevention of complications. A comprehensive STD panel typically includes tests for:
- HIV (both antibody and antigen tests)
- Syphilis (RPR or VDRL, followed by confirmatory tests like FTA-ABS or TP-PA if positive)
- Hepatitis B (HBsAg, anti-HBs, anti-HBc)
- Hepatitis C (anti-HCV antibody test)
- Herpes, type-specific glycoprotein G-based assays can detect HSV-1 and HSV-2 antibodies 1. While blood tests are valuable for these infections, it's essential to note that some STDs like gonorrhea, chlamydia, and trichomoniasis are better diagnosed through urine tests or swabs from potentially infected sites 1. The timing of testing matters significantly - HIV antibody tests may not show positive results until 3-12 weeks after exposure, while syphilis may require testing 1-3 months after potential exposure. Regular screening is recommended for sexually active individuals, especially those with new or multiple partners, with frequency depending on risk factors 1. These blood tests are crucial for early detection, as many STDs can remain asymptomatic while causing serious complications or being transmitted to partners. Key considerations for screening include:
- Risk behavior
- Potential risk behavior of partners
- Incidence of STDs in the local population
- Frequency of screening should be at least yearly if any potential risk exists for STD acquisition, and more frequently if any incident STDs are detected by symptoms or screening 1.
From the Research
STD Blood Tests
The following are some of the blood tests recommended for diagnosing sexually transmitted diseases (STDs):
- Hepatitis B and C tests, which detect the presence of hepatitis B surface antigen (HBsAg), hepatitis B e antigen (HBeAg), and hepatitis C virus (HCV) antibodies 2
- Syphilis tests, which detect the presence of treponemal and nontreponemal (antiphospholipid) antibodies 3, 4
- Human immunodeficiency virus (HIV) tests, which detect the presence of HIV antibodies or antigens 3, 4
- Herpes simplex virus (HSV) tests, which detect the presence of HSV antibodies or antigens, although serology is not always recommended for diagnosis 4
Other Tests
In addition to blood tests, other types of tests may be recommended for diagnosing STDs, including:
- Nucleic acid amplification tests (NAATs) for gonorrhea, chlamydia, and trichomoniasis, which can be performed on urine, pharyngeal, or rectal samples 4, 5
- Rapid plasma reagin (RPR) circle card test for syphilis 2
Populations at Risk
Certain populations are at higher risk for STDs and may require more frequent testing, including:
- People with HIV/AIDS, who are at increased risk for coinfections with hepatitis B and C, syphilis, and other STDs 2
- Men who have sex with men, who are at increased risk for STDs such as gonorrhea, chlamydia, and syphilis 4, 5
- People with a history of intravenous drug use, who are at increased risk for STDs such as hepatitis B and C, and HIV 2